Aphasia is a disruption in a person's ability to use language to communicate with others. The difficulty may be either receptive (the person has difficulty understanding what is said to them or what they read) or expressive (the person has difficulty recalling words or writing). In many cases the person will have a combination of both receptive and expressive difficulties. In addition, the difficulties experienced may range from very mild - the person may have slight difficulties naming things, to more severe - the person is not able to understand or use any language.

Each person with aphasia will differ in their level of severity and areas of language affected. Generally, if a person is having trouble understanding what is said to them, they will also be unable to make sense out of a written message. In a complete communication assessment all four areas (reading, writing, understanding speech and speaking) will determine strengths and weaknesses for that individual.

Because the communication problems of persons with aphasia can vary to such a degree, it is impossible to make suggestions that will cover everyone. If a speech-language pathologist is working with the aphasic person he/she will be able to make appropriate specific suggestions. A few general suggestions are:

• Don't assume that the aphasic person can't understand what is being said. Lack of speech does not necessarily mean total lack of understanding. Avoid speaking about the individual in front of them.
• Continue to speak in a natural voice to the person. Raising your voice will not help the person unless this was necessary before the stroke because of hearing loss.
• People generally follow conversations better when talking to one person at a time.
• People often take hints from the environment, as well as gestures and facial expressions, to help them understand what is said.
• Continue to talk with the aphasic person. Once you know what kind of help a person needs to communicate, then give them that help and do not continue to "test" the person.
• Get the person's attention by saying his/her name before beginning to talk.
• Stand in front of the person when talking so that they can take advantage of facial expressions and gestures.
• Eliminate unnecessary background noise when talking to the person (i.e., turn off the radio, TV or fan, close the door into the hallway).
• Use short simple sentences with everyday language. Give only one message (i.e., "Drink of water?" instead of "On such a hot day I'm sure you would like a drink of water wouldn't you?").
• Pause between sentences (i.e., "Pick up your brush." - "Fix your hair.").
• Use simple yes/no questions which put less demands on the person for a longer response.
• Talk about familiar everyday topics that are important to the person.
• Stick to one topic at a time. Jumping from one topic to another can be very confusing.
• Use specific concrete words such as "bread" instead of "food" or "shirt" instead of "that", "it", "there", etc.
• Be patient and allow the person to speak at his/her own rate.
• Avoid interrupting or supplying words unless the person wants help.
• Avoid speaking for the person unless absolutely necessary.
• Change activities or topics if the person is frustrated (i.e., "I can't understand what you are saying right now, but we will come back to it later.").
• Communicating the idea is far more important than how the person communicates. Accept all means of communicating including gestures, writing, and drawing.

If you require further information, please contact the speech-language pathologist in your health region.